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As I go in for another cancer follow-up, I need to remind myself that what could happen is different from what would happen.
A few weeks ago, I trudged off for yet another six-month follow-up exam. I suppose I should be grateful to still be around for these things, but I’m not. I despise these never-ending reminders the hound of cancer remains at my heels.
For weeks now, with increasing frequency, I find myself bracing for this follow-up. Much like being in a car and seeing a brilliant yellow “Warning Bridge Out Ahead” sign, I attempt to veer away, slow down, anything to avoid it, but it is a date certain. I consider canceling it but what good would that do? Will this be the one where my doctor says, “I’m sorry but …” Or will she say, “Your scans look great, and your tumor markers remain low.” I pray for the latter.
Being eight years out from a collision with pancreatic cancer, I am a unicorn. With few seeing two years, and most not seeing five, reaching eight years makes me a “real miracle boy,” a term one of my doctors coined.
I often wonder why I have survived. I had the standard treatments. Nothing special. A brutal “Whipple procedure” to extract a one-inch tumor sucked up next to my bile duct, followed by six-weeks of radiation and three-months of chemo. My doctor steered me away from a trial. She said it was too risky.
Had I not turned yellow and landed in the ER with a blocked bile duct I would not be tapping out this story. In reading about this hideous type of cancer, most medical sources say once it becomes symptomatic it is far too late to do anything about it. This is not lost on me. My heart aches for the approximately 62,000 people in 2022 alone, who, according to the American Cancer Society, will get the sad news they too have pancreatic cancer.
Like all of us who have gotten this news, we hope we will make it, but realize there is little chance. Yet, we grasp at hope.
But all these years later, I still find myself unable to shake the hound of cancer that chases me. I am all too aware if my cancer were to come back, I am not likely to survive it a second time. Sure, there might be a surgery to remove a new tumor that is if it can be removed. From my reading, this new tumor would likely take up residence near my pancreas, in my liver, or a kidney perhaps.
The doctors call this a “distal” recurrence as if that makes it any better. Of course, this likely would be followed by more chemo and radiation. I try not to dwell on this.
So, how do I dispatch this hound of cancer at my heels?
Recognizing what could happen is not what will happen.
I have friends who always plan for the best. I admire them for this. In their world, sparrows perform Beethoven’s Fifth for them every day, and the smell of ribs smoldering on their backyard BBQ fills the air. Their kids are always on the honor roll, never smoke dope and get admitted to the best schools. Everything works out for them.
And of course, it’s never too hot or too cold. It’sjust right, shirt-sleeve weather. But when things go sideways for them, they find themselves without a plan B, stuck, not having a clue as to what to do.
In my world, and in the world of many other cancer survivors, I find that in planning for things not to go as I wanted (much different than planning for the worst) I am always ready to adapt to my new normal. This allows me to stay agile much like a tennis player who is always up on the balls of their feet ready to return the next volley.
This takes balance. Thinking too much about what could happen causes me undue and unnecessary stress. But thinking about it too little allows me to become lax, and unprepared in every way.
Use the unknown future to live in the present.
None of us knows what our tomorrow holds. But we cancer survivors have the upper hand in this in that we have seen our tomorrows and lived to talk about them. Knowing our cancer could return and there is little if anything we can do about it should cause us to live fully in the present.
Once when I asked my oncologist about the course of my pancreatic cancer she told me, “No one knows.” Frustrated by her glib answer, I asked my primary care doctor who told me, “If you’ve done your bucket list, do it over again.” Some might call it odd, but I have found his stark answer to be comforting.
Focus on the daily ups.
Setbacks, both small and big, happen. It is all too easy to focus on these and not see the flecks of hope right in front of us, tiny flowers, bursts of pink, yellow, and violet all in plain view. Rather than focusing on everything that went wrong, we need to look for what went right, like the email from a high school friend we haven’t seen in years saying, “I heard you had a bout with cancer. How are you doing?” or the kindness of a stranger who stops to help us load our groceries into our car at the supermarket.
I would offer that day in and day out, far more of these things happen to us than we appreciate. We fail to see this human-to-human expression of heartfelt care and people being people caring about us because they can, not because they have to. Some say we should keep a running list of things we are grateful for. I would agree.
Back to my six-month exam. My CT scan, along with my tumor markers showed no evidence of disease: sweet words to any cancer survivor. But my scan showed a small anomaly in my pancreas. To take a closer look a follow-up MRI was ordered. Thankfully, only a pseudo-cyst (a liquid-filled area) this time, but what’s next?
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